title: Establishing standard performance measures for adult brain tumor patients: a Nationwide Inpatient Sample database study.
abstract: BACKGROUND
  The Agency for Healthcare Research and Quality (AHRQ) patient safety indicators (PSIs) and the Centers for Medicare and Medicaid Services (CMS) hospital acquired conditions (HACs) are used to evaluate the safety and quality of health care. We determined the incidence rates of PSIs and HACs among brain tumor patients in the Nationwide Inpatient Sample database (NIS).
  
  
  METHODS
  We queried the NIS for all hospitalizations involving a brain tumor. We determined the incidence rates of various PSIs and HACs among these patients by searching the hospital records for codes in the International Classification of Diseases, 9th Revision indicating each PSI or HAC.
  
  
  RESULTS
  Among the 501 908 hospitalizations involving a brain tumor in the NIS, there were 102 046 occurrences of an AHRQ PSI, with 16% of patients experiencing one or more AHRQ PSI. Among brain tumor patients treated without surgery, 17.2% experienced ≥ 1 PSI. Among brain tumor patients treated with surgery, 9.8% experienced ≥ 1 PSI. The most common PSIs were postoperative respiratory failure, deep vein thrombosis, and sepsis. The total number of HACs associated with brain tumor patients was 13 778, with 2.63% of patients experiencing ≥1 HAC. Among brain tumor patients treated without surgery, 3.0% experienced ≥ 1 HAC. Among brain tumor patients treated with surgery, 7.4% experienced ≥ 1 HAC. The most common HACs were falls and trauma and pressure ulcers. Increasing comorbidity score was associated with increased likelihood of almost all PSIs and HACs.
  
  
  CONCLUSIONS
  These data may be used to determine individual institutional improvements or success by comparison.
authors.affiliation: Corresponding Author: Maryam Rahman, MD, MS, Department of Neurosurgery, University of Florida, PO Box 100265, Gainesville, FL 32610. mrahman@ufl.edu.
authors.forename: Maryam
authors.initials: M
authors.lastname: Rahman
authors.forename: Dan
authors.initials: D
authors.lastname: Neal
authors.forename: Kyle M
authors.initials: KM
authors.lastname: Fargen
authors.forename: Brian L
authors.initials: BL
authors.lastname: Hoh
mesh_terms: D001932:Brain Neoplasms / Q000601:surgery / Q000628:therapy*; D016208:Databases, Factual; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D061214:Patient Safety / Q000592:standards*; D019984:Quality Indicators, Health Care
keywords: brain tumor; hospital acquired condition; patient safety indicators; pay for performance